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To request an amendment, you must send a written request to the Privacy Officer or e-mail it to: [email protected] In addition, you must include a reason that supports your request.In certain cases, we may deny your request for an amendment.

We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain.

Upon request, we will provide any revised Notice to you.

To inspect or copy PHI about you, you must send a written request to the Privacy Officer or e-mail it to [email protected] We may charge you a fee for the cost of copying, mailing and supplies that are necessary to fulfill your request.

We may deny your request to inspect and copy in certain limited circumstances.

If we deny your request for amendment, you have the right to file a statement of disagreement with the decision, and we give you a rebuttal to your statement. You have the right to receive an accounting of the disclosures we have made of PHI about you after April 14, 2003 for most purposes other than treatment, payment, or health care operations.

The accounting will exclude disclosures we have made directly to you, disclosures to friends or family members involved in your care, and disclosures for notification purposes.To request confidential communication of PHI about you, you must submit a request in writing to the Privacy Officer or e-mail it to [email protected] Your request must state how or where you would like to be contacted. Example of How We May Use and Disclose PHI The following categories describe and provide examples of different ways we use and disclose PHI about you. Example: Information obtained by the pharmacist will be used to dispense prescription medications to you.We will document in your record information related to the medications dispensed to you and services provided to you. Example: We will contact your insurer or pharmacy benefit manager to determine whether it will pay for your prescription and the amount of your co-payment.You have the right to request additional restrictions on our use and disclosure of PHI about you by sending a written request to the Privacy Officer or e-mailing the request to [email protected] We are not required to agree to those restrictions. You have the right to access and copy PHI about you contained in a designated record set for as long as JOSEPH PHARMACY maintains the PHI.The 'designated record set' usually will include prescription and billing records.Your Health Information Rights You have the following rights with respect to PHI about you: *Obtain a paper copy of the Notice upon request. Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy.

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